The sudden deaths of a mother's three babies were likely to have been caused by a medical condition and not suffocation, a court has heard.

Trupti Patel, 35, of Maidenhead, Berkshire, denies murdering her two baby sons, Amar and Jamie, and her baby daughter, Mia, between 1997 and 2001.

Professor Peter Fleming, a leading expert in sudden infant death, said all the evidence suggested that Mrs Patel's children had died because their bodies could not metabolise properly and they became very ill, while appearing to be well.

He told the trial at Reading Crown Court he could find "no clear evidence" to suggest that any of Patel's three babies had been smothered or deliberately suffocated.

I can find no convincing evidence that the deaths were caused by applied or imposed injury

Prof Fleming

Prof Fleming told the hearing that in 20 years of investigating sudden infant death, he had seen three other families in which there had been three unexplained deaths of babies.

He said the fact that three of Mrs Patel's children had died did not support the proposition that they must have been smothered.

"I can find no convincing evidence that the deaths were caused by applied or imposed injury," he said.

"I can find considerable evidence that points in the direction of a metabolic disorder, which is compatible with the picture that occurred in all three cases.

'Peak age'

"The most likely explanation is that these children died as a consequence of a metabolic disorder," he said.

Prof Fleming said Jamie, who died when aged
just 15 days, was at the "peak age" to have suffered from a metabolic disorder.

He told the court that the bleeding in Jamie's bowel and low body temperature at the time
of death were consistent with an acute failure of his metabolic system.

Prof Fleming, a professor of infant health at the University of Bristol and a paediatrician at Bristol Royal Children's Hospital, said the evidence also strongly suggested that a metabolic disorder was to blame for the death of Mia.

Sudden collapse

"All of the investigations are suggestive of metabolic disorder (in Mia)," he said.

Prof Fleming, who led a study which looked at 250 infant deaths, said there was nothing to suggest that the death of Patel's first son, Amar, was unnatural.

Prof Fleming told the court that it was extremely difficult even for medical experts to detect acute metabolic disorders and he said that a child may appear to be well right up to the time of their sudden collapse.